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Sponsored by

childrenscancerrun.co.uk

Raising funds for the North of England childrens Cancer Research fund.

Entry Form
The 32nd Childrens Cancer Run
Sunday 11th May 2014

First Name .............................................................................

Last Name ...........................................................................

Title ..........................................................................................

Date of Birth .......................................................................

Address............................................................................................................................................................................................
.............................................................................................................................................................................................................
.....................................................................................................

Postcode ..............................................................................

Email ................................................................................................................................................................................................
Are you participating (Please tick)
Individually

As a school

As a team

5 mile

1 mile (under 7s)

Team Name/School Name .....................................................................................................................................................


T-Shirt Sizes (Please tick)
26-28

30-32

34-36

38-40

42-44

46-48

I wish to enter the Greggs Childrens Cancer Run 2014. I understand that there is a possibility
of injury as with any cross country run or event and I acknowledge that I am taking part at
my own risk.
Signed .................................................................................
For Children taking part under 16yrs: I consent for my child to take part in the Greggs Childrens
Cancer Run 2014. There will be photos taken during the event which may be used in future for
publicity materials, by signing this form you consent to these photos being used.
His/Her age will be: ........................................................ on the 11th May.
Signed: .................................................................................
I have enclosed a cheque for ................... Please make cheques payable to Childrens Cancer Run
and include your name and address on the back of your cheque then return this form along with
your entry fee to: Childrens Cancer Run, The Sir James Spence Institute for Child Health, RVI,
Newcastle upon Tyne. NE1 4LP Demand for this years run is expected to be high, so please return
this form as soon as possible. Entry fees are non returnable.

Entry fee 6.00 (under 16) 12.00 (adults)


Closing date for entry is Thursday 1st May 2014 or when entry limit is reached. Contact us
at Email: childrenscancerrun.co.uk Tel: 0191 282 1322 or 07930 974 913 or enter on line at
www.childrenscancerrun.co.uk

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